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Location

Mahoba district, UP, India
Thematic Intervention: Health and Nutrition


Project Context

Kriti Shodh Sansthan (KSS), Gahrauli was established in 2000 by a group of active and excited youths having its office at Parmanand Tiraha, district Mahoba. KSS was established with the mission to bring about all round development among children in the perennially drought affected Bundelkhand region of Uttar Pradesh state in India, resulting to poor living in permanent food & livelihood crisis. Lack of food and livelihood security coupled with distress migration has further increased the vulnerability of children in the intervention areas. In absence of household’s food security, community have migrated to different places along with their children which are serious impacting children’s access to education, nutrition and protective environment. Nutrition status of children in the intervention area is very poor. Out of 769 children covered under growth monitoring, 20% children are malnourished out which severely malnourished children are as high as 7%. Recurring droughts, migration and issue of availability of adequate food at households level has impacted food intake of children in the areas. There are issues at community level as well with regards to exclusive breastfeeding of children, proper supplementary feeding etc. which needs to be addressed. Access to quality primary health care for mothers and children are major issue in this area due to lack of required trained health care personnel in existing hospitals, PHC, SC and CHC as per IPHS norm. Blood banks in district hospital are also not functional.
KSS believes and practices participatory approaches in community engagement to address social, economic and political issues. KSS has been able to develop its own distinctive identity of working on child rights issues, which are directly related to the felt needs among the community of the area, and with the empowerment of the living conditions thereof. The organization is working in Charkhari block of Mahoba district covering 10 villages and 1,253 households.

Achievements & Impact


Key Result Areas Achievements

Improved Community understanding on issues related to child health and nutrition, behavioral aspect of parenting practices which can enhance nutritional status among children in intervention areas.

* Orientation on maternal health and hygiene, malnutrition and other related issues were conducted. A total of 144 members from mothers committee, 211 adolescent girls and 284 children from children collective attended the orientation.
* 12 mothers committees have been formed in 10 intervention villages with 12 members in each committee. A total of 39 meetings have been conducted with them wherein role and responsibilities of Anganwadi centre, child health & nutrition, issue related to ANC & PNC, immunization etc. were discussed.
* Orientation of 10 children groups and 07 adolescent girls group were done on role and responsibilities of Anganwadi centers, available services, which were attended by 280 adolescent girls and 284 children.

Strengthening institutions related to health and nutrition cares such that children are able to access services under them.

* 16 SAM and 14 MAM children reported positive nutritional grade movement to MAM and normal respectively.
* 91 out of 94 live births were delivered in institutional health care system and also accessed benefits under Janani Suraksha Yojna.
* Ensured 141 children under one year age received full immunized during the year.
* 14 SAM children were referred to Nutritional Rehabilitation Center (NRC).
* 55 children were referred to health care facilities.
* Ensured, 72 household out of 119 identified started receiving essential ration under National Food security Act (NFSA).



Key Result Areas Achievements

Improve livelihoods and food security at family and community level to enhance nutritional intake of children and thereby reducing malnutrition among children.

* Discussions were organized with community on nutritive value of locally available crops and how can children receive maximum nutrition. As a result, 42 families started integrated kitchen garden farming with diverse crops.
* Ensured, 119 eligible households from intervention villages were included in the list of beneficiaries of drought relief programme through liaison with Additional Magistrate, Charkhari.
* Meetings were conducted with Gram Pradhans for implementation of MGNREGA and also to promote works on water harvesting and plantation. As a result discussion, 6 Gram Panchayats has passed resolution for plantation work in their respective villages and budget for the same was sanctioned for purchase of sapling for plantation. Plantation work initiated in Kanera, Kusharma, and Kuroradang villages under MGNREGA.

Other Highlight Processes and Achievements – 2017.
* One Sneha Shivir was organized in Channikhud for 14 days through collaboration with ICDS department and District project office.
* As per government notification, the organization extended support to Anganwadi worker in formation of 12 mothers committee as per norm.
* One Ayurvedic treatment health camp was organized at Bagron village with support of government Ayurvedic health centre of Charkhari benefitting 69 children from the village. Construction of new Anganwadi building at Bamhorikhurd and Damdama has been sanctioned, which were functioning from government primary schools.

Update on knowledge and capacity building workshops that the project team may have organized /participated in them (this is for the project team and not for the community groups):

One in-house capacity building training organized for team members organized to undertaken on issue related to maternal and child care. Also, team members capacitate to undertake exercise at community level to document existing behavior on child health and nutrition.

Update on major events /campaigns that may have taken place on ground: The partner has initiated advocacy processes to raise the issue of maternal deaths in health care institutions in Charkhari block of Mahoba district. The Primary Health Centre (PHC) of Kharela under Charkhari development block serves about 35 villages including 4 CRY supported intervention villages. There have been several complaints from people with regards to negligence of health staffs of the Kharela PHC as well as non-availability of generic medicines. In the first week of September 2017, two maternal deaths reported in the PHC of Kharela (one belonging to village Punnia of Charkhari and another from Kharela itself). In one case, the newborn died after 12 hours of birth and maternal death happened next day. In another case, maternal death happened soon after the delivery. The organization has raised the issues with the Chief Medical Officer (CMO), Mahoba and also submitted memorandum to active health care service of the PHC, proper ANC of pregnant women and PNC of lactating mothers. It also raised the issue of maternal deaths and neo-natal deaths with the District Magistrate and also highlighted through print media.

Apart from this, completed negligence of the hospital authority was also raised by the CWC of Mahoba and issued order to CMO to undertake deaths audit of the cases. Consequently, an inquiry was initiated by the department on lapses in health care facilities. The local MLA was also apprised of the issues and requested to take steps for activation of the health care facilities. As a result of the advocacy processes, the one ANM has been suspended, and notice was served to another ANM and one doctor towards disciplinary action.

Plans


Key Result Areas Program Activities Planned

Improved Community understanding on issues related to child health and nutrition, behavioral aspect of parenting practices which can enhance nutritional status among children in intervention areas.

* Conduct orientation of Matri Samiti (12 Mothers Committee) on their roles & responsibilities, and capacitate them for monitoring & effective implementation of child health and nutrition programme in respective villages.
* Conduct awareness meeting of community in all intervention villages on child nutrition, issue related to early girls marriage, anemia among adolescents, low birth weight, nutritional deficiency among children, its impact on overall growth and development.
* Organize meeting with pregnant / lactating mothers on importance of colostrums feeding, exclusive breast-feeding and complementary feeding / infant & young child feeding practices.
* Facilitate process for participation of target group in Village Health and Nutrition Day organized in ICDS centre.



Key Result Areas Program Activities Planned

Strengthening institutions related to health and nutrition cares such that children are able to access services under them.

* Facilitate processes for community monitoring of Anganwadi centre through ensuring their attendance in meeting of AWC / participation in VHND.
* Mapping of all Anganwadi centers (14) as per norm to assess status of infrastructures and services, children access to Anganwadi centers etc and advocacy with govt. department
* Follow up at Anganwadi centre level for regular growth monitoring of children and ensure registration of malnourished children in Anganwadi centre.
* Facilitate referral services through local Anganwadi centre to Nutritional Rehabilitation Centre (NRC) Mahoba in case of medical complication as identified by ANM / Anganwadi workers.



Key Result Areas Program Activities Planned

Improve livelihoods and food security at family and community level to enhance nutritional intake of children and thereby reducing malnutrition among children.

* Conduct meeting in the community and share the idea of Kitchen garden and motivate the community action to combat nutritional deficiencies among children. * Liaison with district horticulture office with regards to facilities community benefit from of free seeds from office. Mobilize community to raise nursery and develop kitchen garden of locally suitable and nutritionally rich fruit trees and vegetables. * Explore opportunities of dry-land farming and promote cultivation of food items based on feasibility and sustainability in discussion with horticulture department

Financial Summary: January to December 2018


Budget Breakup 2018

Health & Nutrition

11,479

62%

Administration

7,035

38%

Total Grant Approved

18,514

100%